Transmission of Methicillin-Resistant Staphylococcus aureus via Deceased Donor Liver Transplantation Confirmed by Whole Genome Sequencing

Altman, Deena R.; Sebra, Robert; Hand, Jonathan; Attie, Oliver; Deikus, Gintaras; Carpini, Kristin W. Delli; Patel, Gopi; Rana, Meenakshi; Arvelakis, Antonios; Grewal, Paul; Dutta, Jayeeta; Rose, Hannah; Shopsin, Bo; Daefler, Simon; Schadt, Eric E.; Kasarskis, Andrew; Bakel, Harm van; Bashir, Ali Kashif; Huprikar, Shirish

doi:10.1111/ajt.12897

Cited by 42 publications

(47 citation statements)

References 20 publications

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“…The second is TCH1516 [31], which is closer to a recently reported ISMMS1 [32]. This supports the importance of strain variation for these dangerous and highly resistant S. aureus variants.…”

Section: Discussionsupporting

confidence: 72%

A Staphylococcus aureus Proteome Overview: Shared and Specific Proteins and Protein Complexes from Representative Strains of All Three Clades

et al. 2016

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Staphylococcus aureus is an important model organism and pathogen. This S. aureus proteome overview details shared and specific proteins and selected virulence-relevant protein complexes from representative strains of all three major clades. To determine the strain distribution and major clades we used a refined strain comparison combining ribosomal RNA, MLST markers, and looking at highly-conserved regions shared between strains. This analysis shows three sub-clades (A–C) for S. aureus. As calculations are complex and strain annotation is quite time consuming we compare here key representatives of each clade with each other: model strains COL, USA300, Newman, and HG001 (clade A), model strain N315 and Mu50 (clade B) and ED133 and MRSA252 (clade C). We look at these individual proteomes and compare them to a background of 64 S. aureus strains. There are overall 13,284 S. aureus proteins not part of the core proteome which are involved in different strain-specific or more general complexes requiring detailed annotation and new experimental data to be accurately delineated. By comparison of the eight representative strains, we identify strain-specific proteins (e.g., 18 in COL, 105 in N315 and 44 in Newman) that characterize each strain and analyze pathogenicity islands if they contain such strain-specific proteins. We identify strain-specific protein repertoires involved in virulence, in cell wall metabolism, and phosphorylation. Finally we compare and analyze protein complexes conserved and well-characterized among S. aureus (a total of 103 complexes), as well as predict and analyze several individual protein complexes, including structure modeling in the three clades.

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Section: Discussionsupporting

confidence: 72%

A Staphylococcus aureus Proteome Overview: Shared and Specific Proteins and Protein Complexes from Representative Strains of All Three Clades

et al. 2016

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“…Modern genetic tools have greatly expanded our knowledge of the epidemiology of A c c e p t e d M a n u s c r i p t 22 deceased donor liver transplant was confirmed using WGS in a recent report [68].…”

Section: Application Of Genomics In Epidemiological Settings and Outbmentioning

confidence: 95%

Genomic insights into the emergence and spread of international clones of healthcare-, community- and livestock-associated meticillin-resistant Staphylococcus aureus : Blurring of the traditional definitions

Bal

Coombs

Holden

et al. 2016

Journal of Global Antimicrobial Resistance

117

105

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Please cite this article as: Bal AM, Coombs GW, Holden MTG, Lindsay JA, Nimmo GR, Tattevin P, Skov RL, Genomic insights into the emergence and spread of international clones of healthcare-, community-and livestock-associated meticillinresistant Staphylococcus aureus: blurring of the traditional definitions, Journal of Global Antimicrobial Resistance (2010), http://dx.doi.org/10.1016/j.jgar. 2016.04.004 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.  Genomics-based diagnostic tools such as whole-genome sequencing are useful in providing rapid information in relation to epidemiology and outbreaks.

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“…Other cited risk factors for MRSA infection have been summarized elsewhere but include prolonged hospitalization, broad‐spectrum antibiotic use, primary cytomegalovirus infection, extended ICU stay, and peritonitis. Donor‐derived MRSA infections have been described …”

Section: Methicillin‐resistant Staphylococcus Aureusmentioning

confidence: 99%

Multidrug‐resistant organisms in liver transplant: Mitigating risk and managing infections

Hand

Patel

2016

Liver Transpl

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Liver transplant (LT) recipients are vulnerable to infections with multidrug-resistant (MDR) pathogens. Risk factors for colonization and infection with resistant bacteria are ubiquitous and unavoidable in transplantation. During the past decade, progress in transplantation and infection prevention has contributed to the decreased incidence of infections with methicillin-resistant Staphylococcus aureus. However, even in the face of potentially effective antibiotics, vancomycinresistant enterococci continue to plague LT. Gram-negative bacilli prove to be more problematic and are responsible for high rates of both morbidity and mortality. Despite the licensure of novel antibiotics, there is no universal agent available to safely and effectively treat infections with MDR gram-negative organisms. Currently, efforts dedicated toward prevention and treatment require involvement of multiple disciplines including transplant providers, specialists in infectious diseases and infection prevention, and researchers dedicated to the development of rapid diagnostics and safe and effective antibiotics with novel mechanisms of action.Liver Transplantation 22 1143-1153 2016 AASLD. Even with great improvements in infection prevention, surgical technique, and immunosuppression, bacterial infections remain responsible for poor outcomes in liver transplantation (LT). In an era of prolonged wait times, repeated and unavoidable exposures to both health care and antibiotics place LT candidates and recipients at high risk for both colonization and infection with multidrug-resistant organisms (MDROs).Multidrug resistance is frequently defined as bacteria resistant to at least 1 agent in at least 3 different antibiotic classes.(1) Despite this accepted definition, the definitions applied in studies describing MDROs are variable. MDRO colonization has been associated with subsequent infection and surgical complexities, requirement for immunosuppressive therapy, and necessary invasive interventions (eg, central venous catheters, urinary catheters, and mechanical ventilation) also add to the risk of MDRO infection in this susceptible population. In the absence of posttransplant complications, bacterial infections are more common early after LT.(2) Donor transmission of a MDRO has rarely been reported.Delays in effective empirical therapy, lack of experience with older and newer agents, and ever-changing susceptibility profiles in the setting of inadequate source control or selective antibiotic pressures contribute to the difficulties in treating patients infected with MDROs, specifically multidrug-resistant (MDR) gram-negative bacilli. In this review, we highlight risk factors and available treatment for some of the more common and problematic MDROs encountered in LT.

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Transmission of Methicillin-Resistant Staphylococcus aureus via Deceased Donor Liver Transplantation Confirmed by Whole Genome Sequencing

Cited by 42 publications

References 20 publications

A Staphylococcus aureus Proteome Overview: Shared and Specific Proteins and Protein Complexes from Representative Strains of All Three Clades

A Staphylococcus aureus Proteome Overview: Shared and Specific Proteins and Protein Complexes from Representative Strains of All Three Clades

Genomic insights into the emergence and spread of international clones of healthcare-, community- and livestock-associated meticillin-resistant Staphylococcus aureus : Blurring of the traditional definitions

Multidrug‐resistant organisms in liver transplant: Mitigating risk and managing infections

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